SBA provision, antitrust exemption and FTC involvement need to be addressed in Senate, says PIA

Inclusion of a provision in the Affordable Health Care for America Act (H.R. 3962) allowing insurance agents to sell health policies offered by health insurance exchanges is positive, but other issues remain to be addressed in the Senate, according to the National Association of Professional Insurance Agents (PIA).

The language that guarantees agent participation, added at the insistence of Blue Dog Democrats including former PIA member Rep. Charlie Melancon (D-La.), was included in the final version of H.R. 3962 that passed 220-215 in the House on November 7.

"The inclusion of this provision assures that no matter what, consumers will continue to be able to rely on their local professional insurance agent to help them navigate the maze of choices available, both inside and outside these proposed health insurance exchanges," said PIA National President Jon D. Spalding. "This provision needs to be preserved in the Senate."

PIA believes that other elements included in the House bill will have to be fixed or removed in the Senate.

"We remain concerned with language added under a subsection entitled 'Assistance for Small Employers' that designates the Small Business Administration (SBA) to design what is, in essence, a government-run insurance agency for small businesses," said PIA Director of Federal Affairs Mike Becker. "In the House bill, SBA is required to provide educational activities to small businesses, along with distribution of information and 'enrollment and plan selection assistance for employers' for health plans available under the Health Insurance Exchange."

"In short, the SBA would be required to perform the functions of an insurance agency or brokerage for small groups of under 100," Becker said. "PIA opposes this provision because it is unnecessary and it has the federal government set up insurance brokerages in competition with the private sector. Professional, independent insurance agents and brokers already perform all of the services for consumers that the bill would require the SBA to provide. The SBA provision is unnecessary, duplicative and creates needless federal expenditures."

PIA National has joined with a coalition of property/casualty insurers, agents, brokers, and reinsurers to express concern with antitrust provisions included in H.R. 3962. The proposed repeal of the McCarran-Ferguson limited antitrust exemption for health and medical malpractice insurance would disrupt the industry's business environment and create substantial legal uncertainty and unnecessary litigation. In addition, a Congressional Budget Office (CBO) analysis determined that modifying the federal antitrust exemption for health and medical malpractice insurers "will have no significant effect" on premiums charged for private health insurance.

"The antitrust provisions included in H.R. 3962 would have no benefit on health insurance premiums, as the CBO reports, but would spur frivolous litigation," Becker said. "No good would come as a result of these provisions, only more costs and more litigation. We recommend the Senate address these concerns by removing the antitrust provisions from their version of the bill."

As passed, H.R. 3962 would also permit the Federal Trade Commission (FTC) to prepare studies and reports on the entire insurance industry, including property and casualty. PIA said such a broad grant of authority has no place in a bill addressing health insurance.

"Our healthcare system needs improvement - it costs too much for the quality it delivers, too many people cannot afford coverage, if they can find it, and they can lose it for getting sick," Spalding said. "Congress will probably pass something that will be called healthcare reform. The challenge is to build on the private system in a way that doesn't bankrupt Main Street, USA. It is up to us to continue to lead the way for our lawmakers."